Pattern and Outcome of Traumatic Epidural Hemorrhage in Pediatric Population in Emergency Hospital Mansoura University

Background: Epidural hematomas (EDH) constitute approximately 2–3% of pediatric head injuries and are identified in 1–6% of children admitted with traumatic brain injury (TBI). They represent a critical neurosurgical emergency that requires prompt recognition and timely management.  
Aim: To delineate the clinical pattern and short-term outcome of traumatic epidural hemorrhage in pediatric cases, with an emphasis on informing and improving management approaches.
Patients and Methods: In this prospective observational study, patients under 18 years presenting with head trauma were enrolled. Clinical outcomes were assessed by hospital mortality, duration of hospitalization, length of ICU admission, and occurrence of in-hospital complications. Functional recovery at discharge was measured using the Glasgow Outcome Scale (GOS) and the extended Glasgow Outcome Scale (GOSE).
Results: The mean age of the cases was 8.75 ± 4.83 years. The median duration of hospitalization and ICU admission was 9 and 6 days, respectively. Skull fractures were present in 90.5% of cases, and scalp injuries in 93.7%. Age, clinical presentation, and the duration of both hospital and ICU admission were identified through statistical analysis as significant predictors of disability (P < 0.05).
Conclusion: Pediatric EDH is among the most common neurosurgical emergencies and, with appropriate management, can achieve favorable outcomes. Prognosis is influenced by several factors, including age, clinical presentation, mechanism of injury, associated intracranial lesions, hospital and ICU stay, GOS on admission, GOSE at discharge, presence of skull fracture, and the location of the hematoma.